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FAIRHAVEN MEDICAL CENTER LLC

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Company Details

Legal Name: FAIRHAVEN MEDICAL CENTER LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Administratively Dissolved
Formation/ Registration Date: August 4th 2022
Date of Dissolution: January 3rd 2024
Expiration date: 31 Aug 2023
UBI Number: 604 952 625
ZIP code: 98225
City: Bellingham
County: WHATCOM
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 1401 6TH ST, BELLINGHAM, WA, 98225-7057, UNITED STATES

Contact Details

E-Mail: JACOBHILL52@HOTMAIL.COM
Phone Number: +1 360-733-2904

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
JACOB HILL Registered Agent 3220 MACK RD, EVERSON, WA, 98247-9560, UNITED STATES

Key Officers & Management

Name Role Address
JACOB HILL Executor 3220 MACK RD, EVERSON, WA, 98247-9560, UNITED STATES
MACKENZIE SPROULE Executor 3220 MACK RD, EVERSON, WA, 98247-9560, UNITED STATES
JACOB HILL Governing Person 3220 MACK RD, EVERSON, WA, 98247-9560, UNITED STATES

National Provider Identifier

NPI Number:
1265145403
Certification Date:
2023-02-14

Authorized Person:

Name:
MACKENZIE SPROULE
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QH0100X - Health Service Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
8334643389
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